New Client Form

  • Client Information

  • Patient Information

  • MM slash DD slash YYYY
  • If No, Please List Your Other Pets Below:

  • Medical and Surgical Release

    I hereby consent and authorize Dogwood Veterinary Hospital & Laser Center and attending doctors to receive, prescribe for, treat and/or operate upon my pets named on this form. To prevent the spread of infectious diseases and parasites, hospitalized and boarded animals must be current on all vaccines, and free of internal and external parasites. I authorize the doctor to provide vaccines and flea and/or parasite control for my pet at my expense. I take full responsibility for payment of any charges incurred for treatment to my pet or pets. I understand that I am fully, financially responsible for all charges at the time the services are rendered.

    For your convenience, we accept the following forms of payment:

    • CASH
    • SCRATCHPAY
    • DEBIT
    • VISA
    • MASTERCARD
    • AMERICAN EXPRESS
    • DISCOVER
    • CARE CREDIT

    ***ASK US ABOUT PET INSURANCE TODAY!!***

  • MM slash DD slash YYYY